Addressing Gender-Based Harassment of Women Veterans at VA Facilities

NIH RePORTER · VA · I21 · · view on reporter.nih.gov ↗

Abstract

Project Background: Daily public revelations of sexual harassment, frequent media reports from victims accusing perpetrators, and #metoo in social media highlight decades of harassment by those in more powerful positions across many settings. A recent study conducted by our research team revealed that many women Veterans and staff report sexual harassment by male Veterans at VA facilities. In fact, 25% of women Veterans seen in VA primary care across 12 sites reported experiencing harassment from male Veterans while on VA grounds. Similarly, women staff who took part in VA-based focus groups described experiencing unwelcome advances, sexual comments, and being followed outside work. Exposure to harassment was associated with women Veterans delaying or missing care, and feeling unwelcome at the VA. Among staff, it was associated with negative impacts on employee morale, burnout, and turnover. The goal of this pilot study is to identify strategies for addressing harassment of women Veteran VA patients and VA employees. Because harassment is a contentious issue with varying perspectives on what constitutes acceptable versus unacceptable behavior, achieving this goal requires innovative, stakeholder-engaged methods. After obtaining input from subject matter experts, we propose to engage VA stakeholders through public deliberation methods, which are appropriate for addressing value-laden healthcare policy issues about which different stakeholders have entrenched, and possibly conflicting, views. Project Objectives: The Specific Aims are to: (1) identify strategies for addressing harassment of women Veterans and employees; and (2) engage in public deliberation methods at VA Greater Los Angeles (GLA) to design a stakeholder-informed, locally-tailored strategy for addressing harassment. Project Methods: To achieve Aim 1, we will conduct semi-structured interviews with national subject matter experts (n=20). Informed by Aim 1 results, we will then engage VA clinicians, other VA staff, and Veterans (both men and women; n=20) in a series of four structured deliberation sessions designed to elicit in-depth views, with the goal of reaching common ground on how to address harassment. We will evaluate stakeholders' experiences of engaging in these sessions using an adapted version of the Ways of Engaging- Engagement ACtivity Tool (WE-ENACT), a measure developed by the Patient-Centered Outcomes Research Institute. At the end of the deliberation sessions, our objective is to have a locally tailored strategy to test at VA GLA, with support from a future HSR&D IIR. Significance and Relevance to Veterans' Health: The project is guided by a patient-centered, community- engaged research framework that features partnerships between researchers and stakeholders, and cross- communication among stakeholders. As such, the project is responsive to several HSR&D priorities, including patient-centered care and healthcare systems change, as well as HSR&D's cross-cutting method...

Key facts

NIH application ID
10017707
Project number
5I21HX002690-02
Recipient
VA GREATER LOS ANGELES HEALTHCARE SYSTEM
Principal Investigator
Ruth Klap
Activity code
I21
Funding institute
VA
Fiscal year
2021
Award amount
Award type
5
Project period
2018-10-01 → 2020-12-31